Abstract Idiopathic thrombocytopenic purpura (ITP) is the most common cause of acquired thrombocytopenia in children. In 20% of cases, this condition is classified as chronic when the thrombocytopenia is persistent 6 months after diagnosis. The aim of the present study is to identify the potential factors correlating with a favorable outcome in patients with chronic ITP. Some 71 patients affected by ITP were retrospectively analyzed. Results show a higher rate of spontaneous recovery that is statistically significant for patients with platelet count at diagnosis <20,000/µL. These observations suggest the possibility to delay or avoid aggressive surgical treatment for these patients.